Care and Support White Paper, July 2012 Shaun Gallagher Director of Social Care Policy, Department of Health

The reform timeframe Social Care Vision _______ Nov 2010 Social Care Vision _______ Nov 2010 Law Commission Report __________ May 2011 Dilnot Commission Report __________ _ July 2011 Caring for our future - engagement _________ Sept - Dec 2011 Care and Support White Paper Progress report on funding Draft Care and Support Bill __________ July 2012 Care and Support White Paper Progress report on funding Draft Care and Support Bill __________ July 2012 Engagement and pre- legislative scrutiny Legislation

Documents Care and Support White Paper Draft Care and Support Bill Progress Report on Funding Reform Also a range of supporting documents

Funding Reform Progress Report - Response to Dilnot report - Agree principle of a cap on care costs as the right basis for future funding reform - But final decisions subject to Spending Review - Commit now to introduce universal deferred payments for residential care

White Paper – response to engagement During the Caring for our future engagement in autumn 2011, we listened to the views of people who use or who work in care and support across England. While there were many examples of innovation and high quality care, people told us about a range of recurring problems that we need to address to ensure high quality care and support is available to everyone who needs it.  Too often the system only reacts to a crisis.  Society is not making the most of the skills and talents in communities.  People do not have access to good information and advice.  Access to care varies across the country and is confusing.  Carers have no clear entitlements to support.  Not all care is good. The quality of care is variable and inconsistent.  People often have to fight the system to have the joined-up health, care and support they need.  Our growing and ageing population is only going to increase the pressures on the current system.  Too often the system only reacts to a crisis.  Society is not making the most of the skills and talents in communities.  People do not have access to good information and advice.  Access to care varies across the country and is confusing.  Carers have no clear entitlements to support.  Not all care is good. The quality of care is variable and inconsistent.  People often have to fight the system to have the joined-up health, care and support they need.  Our growing and ageing population is only going to increase the pressures on the current system.

The Care and Support White Paper Vision  To promote people’s independence and wellbeing by enabling them to prevent and postpone the need for care and support.  To transform people’s experience of care and support, putting them in control and ensuring that services respond to what they want. Vision  To promote people’s independence and wellbeing by enabling them to prevent and postpone the need for care and support.  To transform people’s experience of care and support, putting them in control and ensuring that services respond to what they want. This means that, in the future, we expect people will be able to say: 1. “I am supported to maintain my independence for as long as possible” 1. “I am supported to maintain my independence for as long as possible” 2. “I understand how care and support works, and what my entitlements are” 2. “I understand how care and support works, and what my entitlements are” 3. “I am happy with the quality of my care and support” 4. “I know that the person giving me care and support will treat me with dignity and respect” 4. “I know that the person giving me care and support will treat me with dignity and respect” 5. “I am in control of my care and support”

Care and Support Bill Complete rewrite of statute going back to 1948 Modernise and simplify But also: –Reframing the legislation to better support person- centred care and support –Clarify and strengthen some areas Major reform – needs detailed scrutiny

1. “I am supported to maintain my independence for as long as possible” To help people stay active, independent and connected in their communities we will:  Stimulate the development of time banking schemes that help people share their time talents and skills with others in their community  Develop, in a number of trailblazer areas, new ways of investing in services that help people to stay independent for longer, such as social impact bonds  Establish a new care and support housing fund, worth £200 million over 5 years to support the development of specialised housing for older and disabled people  Develop evidence base for prevention  In the draft Bill:  Strengthen statutory duties on preventive services  Reflect asset-based approach in statutory framework

2. “I understand how care and support works, and what my entitlements are”  For the first time there will be one place to go to for national information on NHS, social care and public health  Local authorities to develop improved online services such as self-assessment and marketplace  In the draft Bill, strengthening entitlement for all to receive information and advice  We will introduce greater national consistency in access to care and support, through a national minimum eligibility threshold  We will make it easier for people to move between local authority areas by ensuring no- one’s care and support is interrupted by their move  For the first time, carers will be recognised in the law in the same way as those they care for. They will be entitled to an assessment, and support to meet their eligible needs, to help them with their caring role.

3. “I am happy with the quality of my care and support” To ensure people can be confident their care will be of a high standard we will:  Set out clearly what good quality care looks like and what people should expect when using care and support – TLAP to lead further work on this  Develop a range of approaches based on transparency and fuller information on quality of individual care providers – Provider Quality Profiles  In the Bill, strengthen statutory framework for adult safeguarding – and consult on further powers  Move away from crude contracting by the minute and embed commissioning on basis of outcomes and quality  Strengthen legal arrangements for market shaping, offer tailored support to all councils, and consult on steps to address risks to service continuity in cases of provider failure

4. “I know that the person giving me care and support will treat me with dignity and respect” We will put in place more training and development opportunities, so that people are confident that the care workforce will be compassionate and sensitive to their needs.  Skills for Care / Skills for Health to produce code of conduct and recommended new national minimum training standards for those working in care.  Offer personal assistants (PAs), and their employers, greater support and training - through the Workforce Development Fund - to improve recruitment, retention and the quality of the care and support they deliver  Ambition to double the number of care apprenticeships to 100,000 by 2017  Appoint a Chief Social Worker by the end of 2012 to give the social work profession leadership

5. “I am in control of my care and support” To ensure that care and support focuses on meeting people’s individual needs and helping them to achieve their aspirations we will:  Legislate to give people an entitlement to a personal budget as part of their care and support plan, and strengthen our ambitions on direct payments  Increase the availability of independent advice and support to help people with eligible needs to plan and make choices about their care and support  Pilot the introduction of direct payments for people who have chosen to live in residential care, in order to test the costs and benefits  Develop a framework for integrated care between national health and care organisations  Build on the NHS transfer for social care – continue with it, adapted to new NHS structures, and add new money to it (£100m in 2013/14, £200m in 2014/15) to support integrated working

Care and Support Bill – Outline Embedding the principle of well-being (clause 1) Reflecting broader local responsibilities (clauses 2-7) Starting the care and support journey: assessments and eligibility (clauses 8-16) Clear entitlements to care and support (clauses 17-22) Care planning and personal budgets (clauses 23-30) Moving between areas (clauses 31-33) A new framework for adult safeguarding (clauses 34-38) Transition from children’s care and support services (Clauses 39-44) Other provisions (clauses 45-53)

Next Steps The draft Care and Support Bill The draft Care and Support Bill Implementation  Reform of the law is a key step in delivering our vision.  The draft Care and Support Bill will be subject to Parliamentary pre- legislative scrutiny.  The Committee will publish a report at the end of the PLS process – and the Government must respond formally within two months.  We will introduce to Parliament at the earliest opportunity.  The next stage will continue to rely on collaboration and leadership at all levels to deliver this ambitious programme of reform.  We will need to harness the expertise of Local Government, the voluntary sector, the social care workforce, commissioners, and providers to deliver lasting and transformational change.  We will launch a new Care and Support Transformation Group, which will act as an important forum for challenge and peer support.  We will also create a Care and Support Implementation Board, to take ownership of the implementation plan and assurance on delivery of specific milestones.

Key Milestones Now - April 2013 April 2013 on  Publication of White Paper & Draft Bill for comments (July - scrutiny process Autumn, report early 2013)  First steps in Provider Quality Profile live (July)  Consultation on safeguarding intervention powers (July)  Expressions of interest for residential direct payments pilots (Summer)  Further information on housing capital grant, and on social impact bond pilots (Autumn)  Consultation on market oversight; and launch of support scheme for market shaping (Autumn)  Health & Social Care Act changes come into force (April 13)  Additional funding through NHS transfer (£100m April 13, £200m April 14)  NICE formally takes on quality standards in social care (April 13)  Care and Support Bill introduced to Parliament (from May 2013)  Implementation of new legislation (2015 onwards)